Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services-Wa

Organization Nurse Practitioner · NPI 1164673554

Providence Health & Services-Wa is a Nurse Practitioner in Everett, Washington. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

1509 California St
Everett, WA 98201-3540
Phone: (425) 297-5770
Fax: (425) 259-5831
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1164673554
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Asst Secretary-Enrollment · (425) 358-9786
NPI enumeratedOctober 4, 2008
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025
Mailing addressPo Box 31001-4110, Pasadena, CA 91110-4110

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